European Radiology最新文献

{"title":"ΔAverage of long and short axis diameter on non-contrast CT is associated with major pathological response to neoadjuvant immunotherapy in resectable non-small cell lung cancer.","authors":"Jingyi Liu, Mei Xie, Yunze Liu, Jing Shen, Jie Yao, Xinyu Bao, Xin Zhang, Jianlin Wu, Xinying Xue","doi":"10.1007/s00330-026-12716-z","DOIUrl":"10.1007/s00330-026-12716-z","url":null,"abstract":"<p><strong>Objective: </strong>Neoadjuvant immunotherapy for non-small cell lung cancer shows heterogeneous efficacy, and Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1) fails to accurately predict pathological response. The objective was to explore computed tomography parameters associated with neoadjuvant immunotherapy efficacy and compare their performance with RECIST 1.1.</p><p><strong>Materials and methods: </strong>This multicenter retrospective study included 48 patients with resectable stage I-IIIB non-small cell lung cancer who received neoadjuvant immunotherapy between September 2018 and July 2023. Computed tomography density parameters (computed tomography value and relative computed tomography value) and morphological characteristics (mean diameter, volume, surface area) were measured before and after treatment. Major pathological response (≤ 10% residual tumor cells) served as the reference standard. Receiver operating characteristic analysis and logistic regression evaluated parameter performance.</p><p><strong>Results: </strong>ΔMean diameter demonstrated the highest predictive accuracy for major pathological response (area under the curve 0.83, p < 0.001), with 76% sensitivity, 84% specificity, and 79.2% overall accuracy, with numerically higher accuracy than Response Evaluation Criteria in Solid Tumors version 1.1 (72.9%), though no formal statistical test for superiority was conducted. In exploratory multivariable analysis, it was the only parameter retaining independent association with major pathological response (odds ratio 11.91, 95% confidence interval 1.52-93.11, p = 0.018).</p><p><strong>Conclusion: </strong>ΔMean diameter is a promising imaging biomarker for predicting pathological response to neoadjuvant immunotherapy. In this cohort, it showed numerically higher accuracy than RECIST 1.1; however, these findings are hypothesis-generating and require both internal and external validation before clinical implementation.</p><p><strong>Key points: </strong>Question Neoadjuvant immunotherapy for resectable non-small cell lung cancer shows heterogeneous efficacy, and RECIST 1.1 fails to predict major pathological response, requiring reliable biomarkers. Findings ΔMean diameter was associated with major pathological response (AUC = 0.83), showed numerically higher accuracy than RECIST 1.1, and represented an exploratory independent predictor. Clinical relevance This simple computed tomography parameter shows promise for identifying treatment efficacy in non-complete responders, aids personalized therapy decisions, and improves the accuracy of immunotherapy evaluation without complex radiomics or costly positron emission tomography.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8236-8248"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond detection: Does AI see prognosis in mammography?","authors":"Antonio Portaluri, Tianyu Zhang, Ritse M Mann","doi":"10.1007/s00330-026-12767-2","DOIUrl":"10.1007/s00330-026-12767-2","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8525-8527"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A CT-based score for predicting histopathological usual interstitial pneumonia features and predicting disease progression in smokers with fibrotic idiopathic interstitial pneumonia.","authors":"Ryoko Egashira, Kiminori Fujimoto, Kensuke Kataoka, Jun Fukihara, Daisuke Yamada, Mikiko Hashisako, Tomoyuki Fujisawa, Ken Yamaguchi, Takahiko Nakazono, Takafumi Suda, Atsushi Kawaguchi, Yasuhiro Kondoh, Junya Fukuoka, Hiroyuki Irie, Takeshi Johkoh, Osamu Togao","doi":"10.1007/s00330-026-12741-y","DOIUrl":"10.1007/s00330-026-12741-y","url":null,"abstract":"<p><strong>Objectives: </strong>Histopathological usual interstitial pneumonia (UIP) features are associated with progressive fibrosis but may be overlooked in smokers, where emphysema and smoking-related fibrosis complicate CT-based UIP classification. This study aimed to develop and validate a CT-based score to detect histopathological UIP features and to evaluate its association with disease progression in smokers with fibrotic idiopathic interstitial pneumonia (IIP).</p><p><strong>Materials and methods: </strong>This retrospective multicentre study included two biopsy-proven cohorts of smokers with fibrotic IIP: derivation (n = 242; nationwide registry) and validation (n = 126; single-centre database, 2008-2013). Three predefined HRCT findings-upper-lobe irregular lines (U), irregularity of pleural surface (I), and pleural-based basal reticulation (P)-were scored (0/1) and summed as the U-I-P score (0-3). Associations with histopathological UIP features and outcomes were assessed using logistic regression, receiver operating characteristic analysis, Cox proportional hazards models, and bootstrap internal validation.</p><p><strong>Results: </strong>Cohorts were similar (median age 65 vs. 64 years; 88% vs. 87% male). Histopathological UIP features were present in 208/242 (86%) and 109/126 (87%) patients. The U-I-P score independently predicted histopathological UIP features in both cohorts (area under the curve, 0.83 and 0.89; both p < 0.001). Bootstrap validation demonstrated minimal optimism, supporting model stability. The U-I-P score independently predicted disease progression at 1 and 2 years in the validation cohort (p = 0.002 and p = 0.001, respectively).</p><p><strong>Conclusion: </strong>The U-I-P score detects histopathological UIP features and predicts disease progression in smokers with fibrotic IIP, providing a practical imaging biomarker, even in cases with atypical CT patterns.</p><p><strong>Key points: </strong>Question: In smokers with fibrotic interstitial lung disease, emphysema and smoking-related fibrosis complicate CT pattern classification, limiting identification of usual interstitial pneumonia pathology.</p><p><strong>Findings: </strong>The U-I-P (upper-lobe irregular lines, irregularity of pleural surface, pleural-based reticulation) score detected histopathological usual interstitial pneumonia features and predicted progression.</p><p><strong>Clinical relevance: </strong>The U-I-P score aids identification of smokers with usual interstitial pneumonia-type fibrosis and increased risk of progression when biopsy is unavailable, or CT patterns are atypical for usual interstitial pneumonia.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8332-8346"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conservative management of < 3cm anterior mediastinal lesions in lung cancer screening is safe.","authors":"Amyn Bhamani, Chuen R Khaw, Ruth Prendecki, Priyam Verghese, Andrew Creamer, Jennifer L Dickson, Carolyn Horst, Helen Hall, Sophie Tisi, Monica Mullin, Tanya Patrick, John McCabe, Anne-Marie Hacker, Laura Farrelly, Esther Arthur-Darkwa, Neal Navani, Anand Devaraj, Allan Hackshaw, Arjun Nair, Sam M Janes","doi":"10.1007/s00330-026-12700-7","DOIUrl":"10.1007/s00330-026-12700-7","url":null,"abstract":"<p><strong>Objectives: </strong>To determine if a pragmatic, conservative approach to managing < 3 cm anterior mediastinal lesions in lung cancer screening (LCS) is safe.</p><p><strong>Materials and methods: </strong>55- to 77-year-old current or former smokers underwent low-dose computed tomography (LDCT) screening. Anterior mediastinal lesions < 3 cm at baseline were managed conservatively with annual LDCT follow-up for up to 2 years. Lesions ≥ 3 cm at baseline, growing during follow-up (based on visual assessment), or demonstrating concerning radiological characteristics were referred for further assessment. Outcomes for all anterior mediastinal lesions were assessed using follow-up LDCT images, electronic health records and the national cancer registry. Descriptive frequencies were calculated for all reported outcomes.</p><p><strong>Results: </strong>The baseline prevalence of anterior mediastinal lesions was 0.7% (n = 91/12,961). Among 54 participants with < 3 cm lesions who underwent annual LDCT follow-up, 74.1% (n = 40/54) completed 2 years of surveillance, while 26.9% (n = 14/54) required further assessment due to interval growth. Four participants with growing lesions were diagnosed with thymoma following surgery, and one required adjuvant radiotherapy for an R1 resection margin. Among all participants with anterior mediastinal lesions, 16 underwent surgical resection, resulting in eight thymoma diagnoses. The benign resection rate was 50%. No thymic or anterior mediastinal malignancies have subsequently been diagnosed among participants with < 3 cm lesions who completed surveillance within the study over a median follow-up of 1997.5 days.</p><p><strong>Conclusion: </strong>Screen-detected anterior mediastinal lesions < 3 cm at baseline without concerning radiological characteristics can be managed conservatively with annual LDCT follow-up. Referral for further assessment only in the event of interval growth does not appear to compromise clinical outcomes.</p><p><strong>Key points: </strong>Question No standardised approach for managing anterior mediastinal lesions identified incidentally through lung cancer screening currently exists. We aimed to determine if utilising a 3 cm baseline diameter referral threshold for screen-detected anterior mediastinal lesions is safe. Findings 74% of < 3 cm anterior mediastinal lesions remained stable over two annual screening rounds and did not require a secondary care referral. Four (out of 14) individuals with growing lesions during follow-up were diagnosed with thymoma, and one required adjuvant radiotherapy for an incomplete resection. Clinical relevance Utilising a 3 cm baseline referral threshold is safe and may improve the efficiency of large-scale, population-based LCS by reducing referrals to secondary care.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8225-8235"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Toward clinically meaningful benchmarking of large language models for radiology report quality assurance.","authors":"Haoyang Hu","doi":"10.1007/s00330-026-12766-3","DOIUrl":"10.1007/s00330-026-12766-3","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8160-8161"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk factors and carotid plaque components in a multi-ethnic cohort using 3 Tesla MRI: the HELIUS study.","authors":"Esther M C Vriend, Thomas A Bouwmeester, Daniel Bos, Didier Collard, Eric P Moll van Charante, Henrike Galenkamp, Renske Merton, Aart J Nederveen, Pim van Ooij, Oscar H Franco, Bert-Jan H van den Born","doi":"10.1007/s00330-026-12713-2","DOIUrl":"10.1007/s00330-026-12713-2","url":null,"abstract":"<p><strong>Objective: </strong>Carotid plaque composition, including calcifications, lipid-rich necrotic core (LRNC), and intraplaque haemorrhage (IPH), is associated with an increased risk of cardiovascular disease (CVD). Its association with cardiovascular risk factors remains unclear, particularly in midlife and across ethnic groups. We examined the relation between cardiovascular risk factors and carotid plaque components using MRI.</p><p><strong>Materials and methods: </strong>We conducted 3-T MRI of the carotid arteries in 356 Dutch, South-Asian Surinamese, and Moroccan participants from the HELIUS study. Median follow-up time between the cardiovascular risk factor visit and MRI was 8.4 years. Multivariable logistic mixed regression models assessed associations between cardiovascular risk factors and plaque components RESULTS: At baseline, participants had a median age of 54.0 years [IQR: 48.0-59.0] with 42.1% women. Plaque calcifications, LRNC, and IPH were present in 62.6%, 21.3%, and 3.9% of participants, respectively. Hypertension was strongly associated with calcifications (OR 4.02, 95% CI: 1.59-10.12), while smoking was both related to the presence of calcifications (OR 4.94, 95% CI: 1.79-13.62) and LRNC (OR 2.88, 95% CI: 1.30-6.40). The significant associations between both history of CVD and diabetes with calcifications were attenuated after adjusting for other risk factors. No significant associations were found for IPH, likely due to its low prevalence. There were no differences in plaque component prevalence between South-Asian Surinamese and Dutch, while Moroccans had a lower prevalence of calcifications.</p><p><strong>Conclusions: </strong>Unfavourable cardiovascular risk profiles in midlife were associated with an increased prevalence of carotid plaque components later in life, with ethnic differences in their prevalence.</p><p><strong>Key points: </strong>Question There is limited understanding of how cardiovascular risk factors in midlife are associated with carotid plaque components across ethnicities, hampering targeted prevention of CVD. Findings Hypertension and smoking were strongly associated with carotid plaque calcifications; smoking was associated with LRNCs, while for IPH, no associations were found. Clinical relevance Unfavourable cardiovascular risk profiles in midlife increase the prevalence of carotid plaque components later in life, with ethnic differences in their prevalence, highlighting opportunities for personalised, targeted prevention strategies to reduce CVD.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8277-8286"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal bone remodeling after venous stenting for pulsatile tinnitus: isolated dehiscence versus diverticulum.","authors":"Zhiyuan Zhang, Yanjing Han, Tianhao Su, Xiaoyu Qiu, Pengfei Zhao, Long Jin","doi":"10.1007/s00330-026-12711-4","DOIUrl":"10.1007/s00330-026-12711-4","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate clinical outcomes and temporal bone remodeling after venous sinus stenting for pulsatile tinnitus (PT), and to compare remodeling rates between isolated sigmoid sinus wall dehiscence (SSWD) and diverticulum-associated SSWD.</p><p><strong>Materials and methods: </strong>This retrospective cohort study included 70 consecutive patients who underwent venous sinus stenting for PT. Clinical success was defined as symptom improvement or complete resolution. The primary endpoints were short-term clinical success (at 3 months) and temporal bone remodeling on follow-up CT (n = 52). Long-term clinical success was evaluated as a secondary endpoint. Multivariable logistic regression, adjusted for age, sex, dehiscence size, diverticulum presence, and preoperative Tinnitus Handicap Inventory (THI) score, was used to identify predictors of temporal bone remodeling.</p><p><strong>Results: </strong>Short-term clinical success was achieved in 65/70 patients (92.9%). Remodeling occurred in 38/52 patients (73.1%) with follow‑up CT. Remodeling rates were significantly higher in patients with a diverticulum versus isolated SSWD (85.7% (30/35) vs 47.1% (8/17); adjusted OR, 8.08; 95% CI: 1.31-49.73; p = 0.024). Older age independently predicted temporal bone remodeling (adjusted OR per year, 1.14; 95% CI: 1.03-1.26; p = 0.012). Long-term clinical success was observed in 97.4% (37/38) of remodeled patients and 85.7% (12/14) of non-remodeled patients (p = 0.15).</p><p><strong>Conclusion: </strong>Venous sinus stenting for PT results in a high rate of clinical success. The presence of a diverticulum strongly predicts subsequent temporal bone remodeling, whereas SSWD appears less likely to remodel, highlighting potential pathophysiological differences between these anatomical subtypes.</p><p><strong>Key points: </strong>Question Venous sinus stenting for pulsatile tinnitus results in high clinical success, but temporal bone remodeling differs by anatomical subtype. Findings Patients with a sigmoid sinus diverticulum demonstrate significantly higher rates of postoperative bone remodeling compared to those with isolated dehiscence. Clinical relevance Identifying the specific anatomical anomaly may help to predict temporal bone remodeling and facilitate individualized patient counseling regarding long-term structural outcomes.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8123-8131"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of lung imaging at 0.55T for assessment of interstitial lung disease in patients with pulmonary sarcoidosis.","authors":"Maurice Pradella, Hanns-Christian Breit, Jens Bremerich, Constantinos Anastasopoulos, Michael Bach, Oliver Bieri, Katrin E Hostettler, Grzegorz Bauman","doi":"10.1007/s00330-026-12708-z","DOIUrl":"10.1007/s00330-026-12708-z","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the feasibility and diagnostic performance of radiation-free 0.55-T lung MRI for pulmonary sarcoidosis, combining morphological imaging with functional proton MRI ventilation/perfusion metrics, and to explore correlations with pulmonary function testing (PFT).</p><p><strong>Materials and methods: </strong>In this prospective study, 15 patients with pulmonary sarcoidosis and 30 healthy volunteers underwent 0.55-T lung MRI (bSTAR morphology; matrix-pencil based functional proton MRI). CT served as the reference standard for morphological findings (majority vote of experienced readers). Functional maps yielded ventilation defect percentage (VDP), perfusion defect percentage (QDP), and ventilation-perfusion overlap (VQO); thresholds were derived from the healthy cohort. Group comparisons and correlations with PFT were performed.</p><p><strong>Results: </strong>MRI achieved the highest sensitivity for consolidations (86%) and moderate performance for nodules (67%) as well as ground-glass opacities (70%), but lower sensitivity for reticulations (29%) and traction bronchiectases (27%) compared with CT. Inter-reader and inter-modality agreement were moderate. Functional MP-MRI revealed significantly higher VDP, QDP, and VQO in patients compared with volunteers (all p < 0.01). Strong correlations were found between MRI-derived VDP and RV/TLC ratio (r = 0.90, p < 0.001) and between QDP and FEV1 (r = 0.63, p = 0.01).</p><p><strong>Conclusion: </strong>Low-field lung MRI provides complementary information in pulmonary sarcoidosis, enabling structural assessment free of ionizing radiation, with overall moderate agreement compared to CT, and adds valuable regional lung function analysis correlated with PFT.</p><p><strong>Key points: </strong>Question Can 0.55-T lung MRI supplement CT in pulmonary sarcoidosis by providing structural assessment plus regional ventilation and perfusion metrics linked to pulmonary function? Findings 0.55-T MRI showed high sensitivity for consolidations (86%) and revealed increased ventilation and perfusion defects that correlated strongly with the residual volume-to-total lung capacity ratio. Clinical relevance Low-field lung MRI enables radiation-free assessment of structural and functional lung involvement, offering additional regional information that may support longitudinal monitoring in selected patients with pulmonary sarcoidosis.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8311-8321"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"GPT-4.1 and Llama 3.3 70 fail to detect clinically relevant errors in radiology reports in zero-shot evaluation.","authors":"Tugba Akinci D'Antonoli, Lisa C Adams, Jannik Lübberstedt, Markus M Graf, Christian J Mertens, Felix Busch, Sebastian Ziegelmayer, Marcus R Makowski, Keno Bressem, Ina Luiken","doi":"10.1007/s00330-026-12697-z","DOIUrl":"10.1007/s00330-026-12697-z","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether GPT-4.1 and Llama 3.3 70B, large language models (LLMs) assessed in zero-shot, baseline configurations, detect and categorize clinically consequential errors across types that range from pattern-based to reasoning-dependent.</p><p><strong>Materials and methods: </strong>Two hundred fifty-six radiology reports encompassing CT (n = 104), MRI (n = 104), and X-ray (n = 48) studies across multiple anatomical regions were retrospectively analyzed. For each original report, four variants (n = 1024) were generated, each incorporating one of four predefined error types: E1, anatomical mislabeling that could cause wrong-site actions; E2, physiologically impossible or nonsensical findings; E3, diagnostic inconsistencies that affect staging or diagnosis; E4, inappropriate recommendations. The evaluated models were GPT‑4.1 04-14) and Llama 3.3 70B, both used without domain-specific training or prompt optimization to assess baseline model performance.</p><p><strong>Results: </strong>Model performance revealed a systematic hierarchy governed by error type and imaging modality. Physiologically impossible errors (E2) showed the lowest performance: 46.2% (CT) and 33.7% (MRI) for GPT-4.1, compared with 32.7% and 25.0% for Llama 3.3, respectively. Overall success for GPT-4.1 on E2 was 16.3% (CT), 8.7% (MRI), and 12.5% (X-ray). Mislabeling errors (E1) were detected in 49.0% by GPT‑4.1 and 33.7% by Llama 3.3 for MRI. Best performance occurred for inappropriate recommendations (E4), with GPT‑4.1 achieving 85.4% detection in X-ray with high classification accuracy.</p><p><strong>Conclusion: </strong>The evaluation framework and benchmark dataset provide a methodology for assessing LLM performance on clinically significant errors. Applied to GPT-4.1 and Llama 3.3 70B in zero-shot settings, the framework reveals a performance gap between pattern-based and reasoning-dependent error detection that warrants investigation across additional models and optimization strategies.</p><p><strong>Key points: </strong>Question LLMs are increasingly used for quality assurance of radiology reports, but whether their linguistic competence translates into the detection of clinically significant errors remains unclear. Findings Error detection was type-dependent, both GPT-4.1 and Llama 3.3 70B performed poorly on physiologic and anatomical errors, but better on inappropriate recommendations. Clinical relevance LLMs failed to detect most clinically consequential errors in radiology reports, especially physiologically impossible statements that trained radiologists would rapidly identify.</p>","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8149-8159"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148276551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Depot corticosteroid injections in tendinopathy-primum non nocere? Revisiting the risks of intratendinous injection.","authors":"Berkay Yalçınkaya, Ahmet Furkan Çolak, Murat Kara","doi":"10.1007/s00330-026-12684-4","DOIUrl":"10.1007/s00330-026-12684-4","url":null,"abstract":"","PeriodicalId":12076,"journal":{"name":"European Radiology","volume":" ","pages":"8495-8496"},"PeriodicalIF":6.0,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148257876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}